Cervical immobilizing device

ABSTRACT

A cervical immobilizing device includes a pair of arms that can be folded to an upright position to engage and support a patient&#39;s head, an actuating device for folding the arms to the supporting position, and a locking device for locking the position of the arms in the folded supporting position. The actuating device is coupled to the outer ends of the arms for folding the arms to an upright position symmetrically and uniformly. In one embodiment, the actuator device is flexible member that passes around a guide to a position which can be gripped by the user. The locking device can be a cinching, ratcheting or clamping device, or a combination thereof, on the actuator device. In one embodiment, the folding arms include a coupling device for coupling the arms to a base in a sliding arrangement to enable the arms to slide along the base to a folded position. A blank is also disclosed that can be folded to form the cervical immobilizing device.

FIELD OF THE INVENTION

[0001] The present invention relates generally to a head and cervicalimmobilization device. More particularly, the invention is directed to acervical immobilization device that can be erected symmetrically tominimize movement of the head of an injured patient.

BACKGROUND OF THE INVENTION

[0002] During the transport of patients or accident victims that havesuffered cervical injuries, it is essential to immobilize the head andcervical portions to prevent further injury. A variety of head andcervical immobilization devices have been used in the emergency medicalindustry for many years. Several of these devices are designed to foldflat during storage and can be erected when needed.

[0003] One type of head immobilizing device is designed to be attachedto a rigid backboard. Other devices include a rigid structural portionthat do not require the use of a rigid backboard. Examples of this typeof device are disclosed generally in U.S. Pat. No. 4,034,748 to Winner,U.S. Pat. No. 4,211,218 to Kendrick and U.S. Pat. No. 4,594,999 toNesbit.

[0004] Another type of device is disclosed in U.S. Pat. No. 4,928,711 toWilliams. This device is intended to be attached to a rigid backboardfor immobilizing the head of an injured patient. The device includesflexible members that are bent independently to wrap around the sides ofthe head and secure to the base for locking the position of the members.The head supporting members are attached to the base by a hook and piletype fastening device.

[0005] Another form of cervical immobilization device is disclosed inU.S. Pat. No. 4,964,418 to Wilson. This device has a pair of collapsiblemembers for conforming to the patient's head. Rigid support members arethen attached to a base by a hook and loop fastener for restraining thepatient's head and neck.

[0006] The above-noted devices can be effective in immobilizing apatient's head and neck during transport of an injured patient. However,these devices have certain limitations and there is a continuing need inthe industry for improved head immobilizing devices.

SUMMARY OF THE INVENTION

[0007] The present invention is directed to a cervical immobilizationdevice. More particularly, the invention is directed to a collapsiblecervical immobilization device that is folded to an upright position toengage the sides of a patient's head symmetrically during use.

[0008] Accordingly, a primary object of the invention is to provide acervical immobilization device that is compact during storage and can beerected to a supporting position when needed.

[0009] Another object of the invention is to provide a cervicalimmobilization device that can be manufactured economically usinginexpensive and readily available materials.

[0010] A further object of the invention is to provide a headimmobilization device for attaching to a rigid backboard which can befolded to conform to a patient's head that is efficient and easy to use.

[0011] Another object of the invention is to provide a cervicalimmobilizing device that can be made from a folded blank.

[0012] Still another object of the invention is to provide a cervicalimmobilization device having an actuator member that enables headengaging arms to simultaneously and symmetrically engage a patient'shead when folded to an operating position to eliminate or reducemovement of the patient's head.

[0013] Another object of the invention is to provide a cervicalimmobilization device having an actuator device that can be operated bythe user with one hand to symmetrically engage both sides of thepatients head to prevent twisting of the head and to support thepatient's head during transport of the patient.

[0014] The objects and advantages of the invention are basicallyattained by providing a cervical immobilization device comprising a basehaving first and second ends, a first edge and a rear edge, and acervical immobilizing member coupled to the base. The cervicalimmobilizing member is movable from a first position to a second uprightposition for engaging a patient's head. The immobilizing member has acenter portion attached to the base and a pair of movable arms forengaging the patient's head when in the second upright position. Each ofthe arms have an inner edge coupled to the center portion by a pivotalcoupling and an outer edge facing outwardly toward the respective end ofthe base. An actuating device is coupled to each of the outer ends ofthe immobilizing member. The actuating member is able to simultaneouslyslide the outer ends of the cervical immobilizing member from the firstposition toward the center portion to the upright position forsupporting the patient's head. In embodiments of the invention, thecenter portion is a flat panel attached to the base and the arms arecoupled to the center panel by fold lines.

[0015] The objects of the invention are further attained by providing acervical immobilizing device comprising a base having a first and asecond end, a front edge and a rear edge. The base has a first slotextending from the first end toward the center portion of the base and asecond slot extending from the second end toward the center portion ofthe base. A cervical immobilizing member having a center panel isattached to the center portion of the base. The immobilizing memberincludes a first arm having an inner end coupled to the first edge ofthe center panel and an outer end spaced from the inner end. A secondarm having an inner end is coupled to a second side of the center paneland has an outer end spaced from the inner end. Each of the arms includea coupling member for sliding engagement with a respective slot. Anactuating device is coupled to the first and second arms forsimultaneously and symmetrically sliding the outer ends of the first andsecond arms inwardly toward the center panel to fold each of the arms toa substantially V-shaped configuration for engaging and supporting apatient's head.

[0016] The objects of the invention are also attained by providing ablank for forming a cervical immobilizing device where the blankcomprises a first panel having first and second longitudinal ends and acenter panel having longitudinal ends. A first flap is coupled to thefirst end of the center panel by a first fold line and has a second foldline substantially parallel to the first fold line and spaced from thefold line to define an inner and an outer panel. A second flap iscoupled to the second end of the center panel by a first fold line. Thesecond panel has a second fold line parallel to and spaced from thefirst line to define an inner and outer panel. In certain embodiments ofthe invention, a first tab is coupled to the outer panel of the firstflap and a second tab is coupled to the outer panel of the second flap.A connecting panel is coupled to a longitudinal side of the center panelby a fold line. A second panel having longitudinal ends and first andsecond longitudinal side edges is coupled to the connecting panel by afold line along the first longitudinal side edge. The second panel hasat least one first aperture adjacent the first flap and at least onesecond aperture adjacent the second flap.

[0017] These and other objects of the invention will become apparent toone of ordinary skill in the art in view of the following detaileddescription in combination with the annexed drawings, which form a partof this original disclosure.

BRIEF DESCRIPTION OF THE DRAWINGS

[0018] The following is a brief description of the drawings, in which:

[0019]FIG. 1 is a top plan view of a blank for forming the cervicalimmobilizing device in a first embodiment of the invention;

[0020]FIG. 2 is a perspective view of the blank of FIG. 1 in a partiallyfolded position;

[0021]FIG. 3 is a perspective view of the cervical immobilization deviceformed from the blank of FIG. 1;

[0022]FIG. 4 is a top view of the cervical immobilization device formedfrom the blank of FIG. 1;

[0023]FIG. 5 is a bottom view of the cervical immobilization deviceformed from the blank of FIG. 1;

[0024]FIG. 6 is a schematic side view of the actuating device andlocking arrangement of the cervical immobilization device of theembodiment of FIGS. 1-5;

[0025]FIG. 7 is a perspective view of the cervical immobilization devicein a partially erected position;

[0026]FIG. 8 is a partial cross-sectional view of the actuating memberand sliding arrangement for the foldable arms as seen along line 8-8 ofFIG. 3;

[0027]FIG. 9 is a top view of the cervical immobilization device in asecond embodiment of the invention;

[0028]FIG. 10 is a top plan view of the actuator device for the cervicalimmobilization device of FIG. 9;

[0029]FIG. 11 is a top view of the cervical immobilization device of theembodiment of FIG. 9 showing the head supporting arms in the erectedposition;

[0030]FIG. 12 is a top plan view of a blank for forming a cervicalimmobilization device in a third embodiment of the invention;

[0031]FIG. 13 is a top view of the cervical immobilization device formedfrom the blank of FIG. 12;

[0032]FIG. 14 is a bottom view of the cervical immobilization device ofFIG. 13 showing the head engaging arms in the folded position;

[0033]FIG. 15 is a cross-sectional view showing the head engaging armsin the folded position;

[0034]FIG. 16 is a top plan view of a blank for forming a cervicalimmobilization device in a further embodiment of the invention;

[0035]FIG. 17 is a top view of a cervical immobilization device formedfrom the blank of FIG. 16;

[0036]FIG. 18 is a cross-sectional view of the cervical immobilizationdevice of FIG. 17 showing the head supporting arms in the foldedposition;

[0037]FIG. 19 is a top view of a blank in a further embodiment of theinvention; and

[0038]FIG. 20 is a top plan view of the cervical immobilization devicemade from the blank of FIG. 19.

DETAILED DESCRIPTION OF THE INVENTION

[0039] The present invention is directed to a cervical immobilizingdevice that can be folded from a generally flat position during storageto a folded upright position for engaging the sides of the head of apatient. The head immobilizing device of the invention is suitable foruse in combination with a rigid backboard and is generally attached tothe rigid backboard by an adhesive.

[0040] The invention is primarily directed to a foldable cervicalimmobilizing device that includes an actuator that is pushed or pulledby a user to fold two head-engaging arms from a collapsed, generallyflat position to an upright, head engaging position to support each sideof the patient's head. The actuator is able to fold the arms in asubstantially symmetrical fashion to the upright position to reduce oreliminate twisting of the head and to uniformly support each side of thehead. By providing the actuator, which is coupled to each of thehead-engaging arms, each of the arms can be folded at the same time,thereby applying a uniform pressure in opposite directions on each sideof the head and prevent twisting of the neck or lateral movement of thehead that could otherwise occur if the arms were folded one at a time.The device can be made from various materials having sufficient strengthto support the head of a patient. In the embodiments illustrated, thedevice is made of a suitable cardboard material. In further embodiments,the device can be made from plastic materials by injection molding,thermoforming or rotations molding techniques.

[0041] Referring to FIGS. 1-8, a first embodiment of the assembledcervical immobilizing device 10 and blank 22 are shown. As shown inFIGS. 3-5, the device 10 includes a first base panel 12 and a top panel14. The top panel 14 includes two opposing arms 16 that can be foldedfrom a flat position as shown in FIG. 3 to a folded upright position asshown in FIG. 7. An actuating device 20 is attached to each of the arms16 so that the arms 16 can be folded to an upright positionsubstantially simultaneously and symmetrically. Folding the arms 16symmetrically enables the arms to simultaneously engage the two sides ofthe patient's head to minimize movement of the head and spine whileattempting to stabilize an injured patient. In further embodiments, theactuator device is able to move the arms to an upright position one at atime. For this purpose, two actuator devices can be used.

[0042] The cervical immobilizing device 10 of the invention is generallymade from a suitable sheet material having sufficient strength tosupport a patient's head and that can be folded along fold lines orscore lines to allow for simple construction. In embodiments of theinvention, the head immobilizing device is made of corrugated cardboard,although other inexpensive sheet materials, such as plastic, can beused. In further embodiments, the device can be made from separatecomponents that are coupled together.

[0043] In embodiments of the invention, the cervical immobilizing device10 is made from the unitary cut blank 22 as shown in FIG. 1. In theembodiment of FIG. 1, the blank 22 includes a first panel 24 that formsthe top panel 14 of the assembled device 10, a second panel 26 thatforms the base 12 of the device 10 and a third panel 28. The first panel24 has a substantially rectangular shape with outer ends 30 and 32. Thefirst panel 24 is defined by a center panel 34 and first and secondflaps 36 and 38. The first flap 36 is coupled to a side edge of thecenter panel 34 by a fold line 40. The first flap 36 includes anintermediate fold line 41 extending parallel to the first fold line 40to divide the flap 36 into an inner panel 42 and an outer panel 44. Afold line 46 spaced from the end 30 of the first flap 36 forms an endportion 48.

[0044] The outer panel 44 includes cut lines 50 to define a tab 52. Thetab 52 includes a neck portion 54 coupled to the outer panel 44 alongthe fold line 46. A head portion 56 is coupled to the neck portion 54 bya fold line 58. A second fold line 60 spaced from the fold line 58 isalso provided on the neck portion 54 for folding the head portion withrespect to the neck portion 54 as discussed hereinafter in greaterdetail. In preferred embodiments, the head portion 56 has a widthgreater than the width of the neck portion 54. An aperture 61 isprovided in the head portion 56 and an aperture 62 is provided in theneck portion 54 as shown. The second flap 38 is substantially the sameas the first flap 36 so that identical elements are identified by thesame reference number for simplicity.

[0045] The center panel 34 has a first side edge 64 with a coupling tab66 coupled to the center panel along a fold line 68. A second fold line70 defines an intermediate portion 71 and a head portion 72. The headportion 72 includes end notches 74 for engaging a slot.

[0046] The center panel 34 includes a second edge 76 attached to acoupling panel 78 along a fold line 80. In the embodiment illustrated,the coupling panel 78 has a length substantially equal to the length ofthe center panel 34. The second panel 26 is coupled to the couplingpanel 78 along a fold line 82.

[0047] The second panel 26 has a length a width substantially equal tothe length and width of the first panel and includes two substantiallyT-shaped slots 84. Each slot 84 has a longitudinal dimension extendingparallel to a longitudinal dimension of the second panel 26. The slot 84has a width at least equal to the width of the neck portion 54 of thetab 52 and less than the width of the head portion 56. At the outermostend of the slot 84, leg portions 85 defining the T-shape are provided todefine a width at least equal to the width of the head portion 56. In afurther embodiment, a single slot can be formed having a length toaccommodate each of the tabs 52.

[0048] A second connecting panel 86 is coupled to the second panel 26 bya fold line 88 and is positioned opposite the coupling panel 78.Connecting panel 86 includes a longitudinal slot 90 dimensioned toreceive the coupling tab 66 when the blank 22 is folded to form theimmobilizing device 10. The third panel 28 is coupled to the connectingpanel 86 along a fold line 92.

[0049] The third panel 28 has a longitudinal dimension substantiallyequal to the longitudinal dimension of the first and second panels. Sideedges 94 of the third panel 28 extend perpendicular to a rear edge 95and have a dimension substantially equal to the width of the secondpanel 26. In the embodiment illustrated, front edges 96 are angled withrespect to the side edges 94 to converge at a leading edge 98. Twolongitudinal slots 100 are cut in the third panel 28 and have a lengthsubstantially equal to the slots 84. The slots 100 have a width at leastas wide as the width of the head 56 of tab 52 so that the head 56 canslide freely along the length of the slot 100. Alternatively, a singleslot can be formed to receive the head 56 of each tab 52. An aperture102 is cut in the third panel 28 proximate the leading edge 98. A slit104 extends from the aperture 102 toward the leading edge 98.

[0050] As shown in FIG. 1, an end panel 106 is coupled to the leadingedge 98 of the third panel 28 along a fold line 108. The end panel 106has a width substantially equal to the length of the leading edge 98 andparallel sides 110 extending perpendicular to the edge 98. An elongatedslot 112 extends from an outer end 114 parallel to the sides 110 and isgenerally aligned with the aperture 102. The slot 112 includes sideedges 116 that are substantially straight and terminate in a curved,convex portion 118.

[0051] As shown in FIG. 2, the immobilizing device 10 is assembled byfolding the first panel 24 along fold lines 80 and 82 onto the secondpanel 26 in the direction of arrow 120 and the tab 66 is inserted intothe slot 90. The second panel 26 is folded along fold lines 88 and 92onto the third panel 28 in the direction of arrow 122. The end panel 106is folded along fold line 108 onto the third panel 28 and secured inplace by a suitable adhesive or fastener. The second panel 26 is securedto the panel 106 by an adhesive. For purposes of illustration, the tabs52 are shown folded upwardly from the plane of the first panel 24.During assembly of the immobilizing device 10, the tabs 52 are foldeddownwardly and inserted through the slots 84 so that the head portion 56is on the opposite side of the second panel 26 from the first panel 24.The slots 84 and 100 are superimposed so that the head 56 of tab 52 isable to slide.

[0052] As shown in FIG. 3, the assembled immobilizing device 10 includesthe base 12 formed by the second panel 26 and a top panel 14 formed bythe first panel 24. The flaps 36 and 38 of the blank 22 form the foldingarms 16. The tab 52 is folded along the fold lines 58 and 60 so that thetab 52 couples the arms 16 to the base 12 in a sliding manner. In thisembodiment, the actuating member 20 is a flexible cord or string. Eachend of the cord passes through the apertures 60 and 61 of a respectivetab 52. The end panel 106 forms a guide on the third panel 28 for thecord 20. As shown in FIG. 4, the cord passes between the arms 16 and thebase 12 and around the convex portions 118 of panel 106 and along theopen slot 112. As shown schematically in FIG. 6, the end of the cord 20passes downwardly through the aperture 102 in the third panel 28 to forma loop 124. The remaining portion of the cord 20 that is not passedthrough the aperture 102 is pulled through the loop 124 to form a secondloop 126. A fastener 127 can be attached to the cord to secure the twosections of the cord together.

[0053] The immobilizing device 10 is generally intended to be used incombination with a rigid backboard (not shown). For this purpose, adouble-faced adhesive strip 128 is provided on the bottom face of thethird panel 28 along each edge as shown in FIGS. 4 and 5. A releaselayer 130 having a tab 132 extending outwardly from the top edge of thedevice covers the adhesive strip 128. The immobilizing device 10 ispositioned on a rigid board or other substrate and the release layer 130is pulled to separate the release layer from the adhesive strip andexpose the adhesive, whereby the device can be attached to the board.

[0054] In a preferred embodiment, the release layer 130 has a lengthlonger than the length of the adhesive strip 128. The tacbi 132 isfolded along a fold line 133, generally at about a 450 angle, to extendperpendicular to the longitudinal dimension of the adhesive strip. Therelease sheet is removed by pulling in a direction generallyperpendicular to the adhesive strip, which peels the release layer fromthe adhesive.

[0055] In use, the immobilizing device is placed under the head of apatient with the center panel 34 positioned directly below the patient'shead. The center panel 34 is generally dimensioned to accommodate thehead of a patient. The actuating device 20 is pulled in the direction ofarrow 129 of FIG. 7 to apply a tension to the ends of the cord coupledto the tabs 52. Pulling on the actuating device 20 in a preferredembodiment applies a simultaneous and symmetrical force to the tabs 52which pulls the outer ends of the arms 16 inwardly toward the centerpanel 32 in the direction of arrows 131. As the outer ends of the arms16 are drawn toward the center panel 34, the arms 16 fold along the foldlines 40 and 46, whereby the arms 16 assume a folded, upright,substantially inverted V-shaped configuration as shown in FIG. 7. Theinner panels 42 preferably simultaneously contact the opposite sides ofthe patient's head with substantially uniform pressure and tension toeliminate or reduce movement of the patient's head during the folding ofthe arms 16. Alternatively, the actuating device 20 can be arranged toapply a non-uniform force against each side of the patient's head asneeded and to separately move the arms from the flat position to thefolded upright position. For example, the length of cord attached toeach tab can be pulled separately to separately raise each arm to thefolded position. In still further embodiments, two separate actuatordevices can be included to selectively move the arms to the uprightposition at a desired time.

[0056] Once the arms 16 are folded to the desired upright position, theposition of the arms is locked by pulling on the cord 20 to tighten thefirst loop 124 around the cord and to pull the cord 20 into the slit104. The slit 104 is sufficiently thin to frictionally grip the cord 20.The loop arrangement of the cord 20 enables the cord to be cinched andheld in a fixed position and to provide infinite adjustment of theposition of the arms 16 with respect to the base 12. The inner panels 42are preferably able to bend slightly to conform to the shape of thepatient's head as the cord is pulled and support the user's head bypreventing movement and preventing further injury. A plurality of foldlines (not shown) can be provided on the inner panels 42 to allow theinner panels to fold and conform to the patient's head. The patient canbe removed from the device 10 by loosening the loop 124, therebyloosening the cord and allowing the arms 16 to be unfolded and movedaway from the patient's head. In actual use, an adhesive backed tape orstrap is generally attached to the arms 16 and passed over the foreheadof the patient to secure the patient's head to the immobilizing device10.

[0057] It will be appreciated that the cervical immobilizing device 10can be made from a folded blank having an arrangement of panelsdifferent from the embodiment of FIG. 1. In further embodiments, thepanels can be separate elements that are assembled and secured togetherby adhesives or other fasteners. Other locking devices can be used tolock the actuator device in a fixed position and retain the arms in theupright position. For example, a post or button-like device can beattached to the upper surface of the immobilizing device so that a cordcan be wrapped around the post to secure the cord in place.

[0058] A second embodiment of the cervical immobilizing device 133 ofthe invention is illustrated in FIGS. 9-11 and is similar to theimmobilizing device 10 of the embodiment of FIG. 1 except for theactuating device 134. The cervical immobilizing device 133 of thisembodiment is made from a blank substantially the same as the blank 22of FIG. 1. Accordingly, identical components and parts of theimmobilizing device 133 are identified by the same reference number. Inthis embodiment, the actuating device 134 includes a body portion 136having a plurality of ratcheting teeth 138 on opposite sides of the bodyportion 136. A gripping end 140 is provided in the form of a loop. Inthis embodiment, a slit 142 is provided along the fold line 108 having alength substantially equal to the width of the body portion 136 and lessthan the outer dimension of the teeth 138. A transverse slit 144 is cutperpendicular to the slit 142 to allow the loop 140 to be inserted andpositioned in the slit 142. In the embodiment illustrated, thetransverse slit 144 is formed in panel 106 so that the slit 144 appearson the top portion of the device 133. Alternatively, the slit 144 can beformed in the panel 28 to appear on the bottom of the device 133. Asshown in the cut-away view of FIG. 9 and the top view of FIG. 8, theactuating device 134 includes two flexible leg members 146 extendingfrom the body portion 136 to the tabs 52. The flexible legs 146 includean enlarged T-shaped head 148 for passing through the apertures 61 and62 and coupling with the tab 52.

[0059] The immobilizing device 133 of the embodiment of FIGS. 9-11 isused in a similar manner as the embodiment of FIGS. 1-8. Basically, theimmobilizing device 133 is fixed to a rigid backboard and the patient'shead is placed on the center panel 34 with the actuating device 134extending away from the patient's body. The loop 140 is pulled away fromthe immobilizing device 133 so that the flexible legs 146 of theactuating device 134 pull the ends of the arms 16 toward the centerpanel 34 and fold the arms 16 along the fold lines 40 and 41 to theupright position. The actuating device 134 is pulled until the teeth 138pass through the slit 142 so that the teeth engage the sides of the slit142 to lock the actuating device 134 in a fixed position, therebylocking the arms 16 in a folded, upright position. As can be seen inFIG. 11, the teeth 138 form a one-way ratchet mechanism with the slit142 for adjusting and locking the position of the arms 16.

[0060] FIGS. 12-15 illustrate a third embodiment of the invention. Inthis embodiment, the immobilizing device 150 is similar to the device ofFIG. 1 so that similar elements are identified by the same referencenumber. FIG. 12 shows a blank 151 for forming the immobilizing device150 and includes panels 24, 26, 28 and 106 that are substantially thesame as the previous embodiments. This embodiment differs primarily fromthe embodiment of FIG. 1 in that the outer panels 44 include a cutportion 50 to form tabs 152 having a substantially trapezoidal-shapedhead 154. As shown, the head 154 includes angled sides 156 whichconverge toward the neck portion 158.

[0061] The slots 100 in panel 26 include a plurality of teeth 160extending inwardly from each side of the slot. The teeth 160 aredimensioned to interlock with the angled sides 156 of the tabs 152. Asshown, the teeth have a first face 161 angled in the direction of theouter edges and a second face 163 extending substantially perpendicularto the side edge of the slot 100. Alternatively, a single slot can beformed to accommodate the tabs 152. A hole 162 is punched along the foldline 108 for the actuating device 164.

[0062]FIG. 13 is a top view of the assembled immobilization device 150.As shown, the actuating device 164 is a flexible member such as a stringor cord attached to each coupling tab 152 and passes through the hole162 around each of the convex surfaces 118. The actuating device 164 ispulled outwardly from the immobilizing device 150 which pulls the tabs152 and the outer ends of the arms 16 toward the center panel 34 as inthe previous embodiments to the upright folded position as shown in FIG.15. As shown in FIG. 14, pulling the actuating device 164 pulls the tabs152 along the slot 100 where the sides 156 engage the teeth 160 in aratcheting motion. The edges 156 engage the teeth 160 to lock the tabs152 in a fixed position. As shown in FIG. 15, the teeth 160 allow thetabs to slide or ratchet in the direction of center panel 34 and preventthe tabs 152 from sliding back to the original position. In furtherembodiments, the tabs 152 can be moved manually by the user by pushinginwardly on each tab until the teeth 160 engage the edges of the tab tolock the tabs in position. In this embodiment, the actuator device canbe eliminated where the tabs are to be moved manually.

[0063] Referring to FIGS. 16-18, a further embodiment of the inventionis illustrated. This embodiment is similar to the previous embodiments,except that the cervical immobilizing device 170 is formed from twolayers of material superimposed on one another. The cervicalimmobilizing device 170 is formed from a blank 172 as shown in FIG. 16.The blank 170 includes a first panel 174 and a second panel 176. Thefirst panel 174 includes an outer portion 178 extending the length ofthe first panel in the longitudinal direction and is integrally formedwith a center panel 180. The center panel 180 has a longitudinal edge182 coupled to a coupling panel 184 by a fold line 186. The center panel180 also has transverse side edges 189 coupled to identical flaps 188 byfold lines 190. Each of the flaps 188 have a longitudinal dimensionextending to the edge of the outer portion 178. The flaps 188 include acenter fold line 192 to define an inner panel 194 and an outer panel196. A coupling tab 198 extends from the edge 200 of the outer panel196. A pair of apertures 202 are formed in the outer panel 196 adjacentthe coupling tab 198.

[0064] The center panel 180 includes a center aperture 204 having agenerally triangular shape. The aperture 204 has a first edge 206extending in the longitudinal direction of the first panel 174 and has alength slightly greater than the width of the center panel 180 so thatthe aperture 204 extends into each inner panel 194. A second edge 208and a third edge 210 extend from the first edge 206 and converge to anapex 212. The second and third edges have a generally convex shape asshown in FIG. 16. As shown, each of the side edges join an adjacent sideedge at a generally curved intersection.

[0065] The coupling panel 184 is coupled to the second panel 176 by afold line 214. The second panel 176 has an overall dimension and shapesubstantially the same as the first panel 174. As shown in FIG. 16, aplurality of spaced-apart slots 216 are formed in the second panelextending in a generally transverse direction with respect to thelongitudinal dimension of the second panel 176. The slots 116 have alength and width sufficient for receiving the coupling tab 198. Acentral aperture 218 is provided in the second panel 176 proximate theouter longitudinal edge 220 of the second panel 176.

[0066] The cervical immobilizing device 170 as shown in FIG. 17 isformed by folding the first panel 176 along fold lines 186 and 214 sothat the first and second panels are superimposed on one another. Theouter portion 178 of the first panel 174 and the center panel 180 arepreferably attached to the second panel 176 by a suitable adhesive orfastening device. An actuating device 222 is coupled to the outer endsof the flaps 188 adjacent the coupling tabs 198. The actuating device222 extends between the first and second panels toward the centeraperture 204 and is guided along the convex edges 208 and 210 to theaperture 218. The actuating device 222 extends through the aperture 218and extends beyond the edge 220 of the panels 174 and 176 a sufficientdistance to be gripped by a user. In the embodiment illustrated, theactuating device 222 is a flexible cord having each end attached to arespective end of the first panel. A suitable clamping device 224 isprovided on the actuating device 222 to limit the movement of theactuating device through the aperture 218. The clamping device 224 canbe a spring biased clamp capable of gripping the actuating device andpreventing the actuating device from retracting in the immobilizingdevice 170.

[0067] A top panel 226 is positioned over the center panel 180 to coverthe aperture 204. Preferably, the top panel 226 is dimensioned tocompletely cover the center panel 180 and is attached thereto by asuitable adhesive or other fastening device. Generally, the top panel226 is a flexible cushioning foam for supporting a patient's head,although other materials can be used.

[0068] The cervical immobilizing device 170 is used in a similar mannerto the previous embodiments. As in the previous embodiments, the device170 is attached to a rigid backboard by adhesive strips 228 on thebottom side of the second panel 176. A patient's head is placed on thetop panel 226 with the actuating device 222 extending away from thepatient's body. The actuating device 222 is pulled away from the centerpanel 180 which draws the outer edges of the flaps 188 inwardly towardthe center panel. As the actuating device pulls the outer edges of theflaps 188 toward the center panel, the flaps 188 fold along the foldlines 190 and 192 to an upright position as shown in FIG. 18.

[0069] The actuating device 222 pulls the outer edges of the flaps 188to an upright position in a symmetrical fashion to avoid or reducemovement of the patient's head during the use of the device. Thecoupling tabs 198 slide along the second panel 176 and are received inone of the slots 216 to lock the outer panel 196 in a fixed position.The different slots 216 allow selective adjustment of the position ofthe coupling tabs 198 to accommodate different patients. Although fourslots are shown for each of the coupling tabs 198, it will beappreciated that additional or fewer slots can be used as needed toaccommodate different size patients.

[0070] The actuator device 222 is pulled to a position where the innerpanels 194 contact the patient's head and conforms to the shape of thepatient's head and the coupling tab 198 is positioned in the appropriateslot 216. The suitable strap or tape is then placed across the foreheadof the patient and attached to the immobilizing device 170 to secure thepatient's head in a fixed position. The clamping device 224 can be slidalong the actuating device 222 until it engages the edge of the device170 to prevent the actuating device 222 from retracting into the deviceand allowing the flaps 188 to unfold or return to their originalposition. In further embodiments, the arms 188 can be moved individuallyby manually pushing the arms inwardly to the folded upright position andlocked in place by inserting the tabs 198 into a selected slot 216. Inthis embodiment, the actuator device can be eliminated.

[0071] In a further embodiment, the cervical immobilizing device 240 isformed from two superimposed panels 242 and 244 as shown in FIGS. 19 and20. The immobilizing device 240 can be formed from separate panels thatare bonded together. In the illustrated embodiment, the device 240 ismade from a fold blank 246 of cardboard or other material as shown inFIG. 19. The blank 240 includes the first panel 242 and the second panel244 coupled together along a fold line 248. The first panel 242 and thesecond panel 244 are substantially the same shape and size.

[0072] The first panel 242 includes a center panel 250 and cut lines 252to form a top portion 254 and arms 256. Each arm 256 is coupled to theside edges of the center panel 250 by a fold line 258. The arms 256include an intermediate fold line 260 to define an inner panel 262 andouter panel 264. An aperture 266 is formed in each of the outer panels264 adjacent the outermost edges.

[0073] The top portion 254 of panel 242 has a longitudinal dimensionequal to the combined longitudinal dimension of the arms 256 and thecenter panel 250. The top portion has a generally truncated triangularshape with side edges 268 converging toward the fold line 248. A slit278 is formed along the fold line 248. The center panel 250 includes agenerally T-shaped aperture 270 having a base portion 272 extending inthe direction of the fold line 248 and a pair of arm portions 274. Asshown in FIG. 19, arm portions 274 have a curved portion 276. The armportions 274 have a length to extend a slight distance past the foldlines 258 into the inner panels 262.

[0074] The cervical immobilizing device 240 is formed by folding theblank 246 along the fold line 248 and attaching the panels 242 and 246together. Generally, the top portion 254 and the center panel 246 areattached to the second panel 244 by a suitable adhesive. The arms 256,as in the previous embodiments, are movable with respect to the secondpanel 244.

[0075] An actuating device 280 is attached to each end of the arms byinserting the free end through the apertures 266. The actuator device280 is substantially the same as in the previous embodiments soidentical elements are identified by the same reference numbers. The endof the actuator fed through a transverse slit 282 in the second panel244 and positioned in the longitudinal slit as shown in FIG. 20. Theflexible legs of the actuator device extend around the curved portions276 of the aperture 270, which serve as a guide for the flexible legs. Aflexible cushion or pad 284 is generally attached to the center panel tocover the aperture in the center panel.

[0076] The cervical immobilizing device 240 is used in a similar manneras the previous embodiments. The actuator device 280 is pulled by theuser so that the arms 256 are moved to a folded upright position as inthe previous embodiments. The teeth of the actuator device are pulledthrough the slit 282 to engage the walls of the slit 278 and lock thearms in the folded position.

[0077] Several embodiments have been chosen to illustrate the invention.It will be appreciated by those skilled in the art that various othermodifications and embodiments can be constructed without departing fromthe various features of the invention. For example, the actuating devicein each of the illustrated embodiments is a flexible member that ispulled away from the device to pull the outer ends of the support armsof the device toward the patient's head to a locked position. In furtherembodiments, the actuator device can be an assembly of flexible or rigidcomponents or levers that can be either pushed or pulled to draw thearms from the flat position to the upright position for engaging thepatient's head. In a further embodiment, the actuator device can includea pair of rigid levers extending from the outer ends of the arms andcoupled together by a pivot mechanism at the center of the device. Anarm or lever can be attached to the pivot device that can be pulled orpushed causing a scissor-like action of the rigid members to pull theouter ends of the flaps toward the center of the device. In a similarmanner, the locking device can be other arrangements for fixing theposition of the arms in the folded position during use.

What is claimed is:
 1. A cervical immobilizing device, comprising: abase having first and second ends, a front edge and a rear edge; acervical immobilizing member coupled to said base and being foldablefrom a first position to a second folded position for engaging apatient's head, said cervical immobilizing member including a centerportion attached to said base and including a pair of movable arms forengaging said patient's head when in said second position, said armshaving a first pivotal coupling for coupling an inner edge of said armsto said center portion and an outer edge facing outwardly toward arespective end of said base; and an actuating device coupled to each ofsaid outer ends of said arms, said actuating device being disposed forsliding said outer ends of said arms from said first position towardsaid center panel to said second folded position for supporting saidpatient's head.
 2. The immobilizing device of claim 1, wherein saidcenter portion comprises a center panel and each said foldable armsinclude a second pivotal coupling spaced from said first pivotalcoupling to define an inner panel adjacent said center panel and anouter panel.
 3. The immobilizing device of claim 2, wherein saidcervical immobilizing member is a unitary member and said first andsecond pivotal couplings are fold lines.
 4. The immobilizing device ofclaim 2, wherein each of said arms include a coupling member, and saidbase includes at least one elongated slot, wherein said coupling membersare received in said at least one elongated slot for sliding movementfrom a first position to a second folded upright position.
 5. Theimmobilizing device of claim 2, wherein said coupling members are tabscoupled to said arms proximate said outer edges, said tabs having a neckportion and a head portion, said head portion having a width greaterthan a width of said at least one slot of said base for slidablycoupling said tab to said base.
 6. The immobilizing device of claim 5,further comprising a bottom panel coupled to a bottom side of said base,said bottom panel having at least one elongated slot superimposed withsaid at least one slot of said base, said at least one slot in saidbottom panel having a width at least as great as the width of said headportion of said tabs.
 7. The immobilizing device of claim 5, whereinsaid actuating device is a flexible member coupled to each of said tabsfor simultaneously sliding said arms to said second folded position. 8.The immobilizing device of claim 5, wherein said actuating device is aflexible cord.
 9. The immobilizing device of claim 7, further comprisinga guide member positioned on a bottom face of said base for guiding saidactuating device.
 10. The immobilizing device of claim 9, wherein saidguide member has a first end substantially aligned inwardly with respectto said tabs, an elongated slot extending inwardly from said first endtoward a second end of said guide member, wherein said actuating memberpasses through said slot from said first end to said second end, wherebypulling said actuating member through said slot pulls the ends of saidarms toward said center panel to said folded position.
 11. Theimmobilizing device of claim 1, further comprising a locking device forlocking the position of said actuating device.
 12. The immobilizingdevice of claim 10, further comprising a bottom panel adjacent a bottomside of said guide member and said base, said bottom panel having anaperture, and wherein an end portion of said actuating member extendsthrough said aperture to form a loop, and a second portion of saidactuating member passing through said loop, whereby said loop can betightened around said second portion to lock the position of saidactuating member.
 13. The immobilizing device of claim 10, wherein saidactuating member includes a body portion having a plurality of teeth anda pair of flexible legs, each of said legs being coupled to a respectivearm of said immobilizing member, and wherein said immobilizing deviceincludes an aperture, and said body portion of said actuating memberpassing through said aperture whereby said teeth of said body portionengage a side wall of said aperture to lock said actuating member in afixed position.
 14. The immobilizing device of claim 6, wherein saidhead portion of said tabs have a substantially trapezoidal shape, andwherein said at least one slot in said bottom panel include a pluralityof inwardly directed ratcheting teeth for interlocking with said head ofsaid tabs and resisting sliding movement of said tab in said slots in adirection away from said center panel.
 15. The immobilizing device ofclaim 1, wherein each of said arms include a coupling tab extending fromsaid arms, and said base includes a plurality of spaced-apart aperturesdimensioned for receiving said tab for locking said arms in said foldedposition.
 16. The immobilizing device of claim 15, wherein saidapertures in said base are slots having a longitudinal dimensionextending in a generally transverse direction with respect to alongitudinal dimension of said base.
 17. The immobilizing device ofclaim 1, wherein said center panel includes an aperture, said aperturehaving opposing side walls forming a guiding device for guiding saidactuating device.
 18. The immobilizing device of claim 17, wherein saidbase includes an aperture aligned with said aperture of said centerpanel, and wherein said guiding device guides said actuating devicethrough said aperture in said base.
 19. The immobilizing device of claim18, wherein said actuating device is a flexible member coupled to eachof said arms and extending over said guiding device through saidaperture in said base, whereby pulling said flexible membersymmetrically folds said arms simultaneously to said second foldedposition.
 20. The immobilizing device of claim 19, further comprising alocking device for locking said flexible member in a fixed position withrespect to said base.
 21. The immobilizing device of claim 1, furthercomprising an adhesive covering a portion of a bottom surface of saidbase, and a release liner covering said adhesive, said release linerhaving a length greater than a length of said adhesive to form an endtab, said end tab being folded along an angle with respect to alongitudinal dimension of said release liner and having a length toextend beyond an outer edge of said base.
 22. A cervical immobilizingdevice, comprising a base having first and second ends, a front edge anda rear edge, said base having a first longitudinal slot extending fromsaid first end toward a center portion of said base and a secondlongitudinal slot extending from said second end toward said centerportion of said base; a cervical immobilizing member having a centerpanel attached to said center portion of said base, a first arm havingan inner end coupled to a first edge of said center panel and an outerend spaced from said inner end, and a second arm having an inner endcoupled to a second side of said center panel and an outer end spacedfrom said inner end, said first arm having a first coupling member forsliding engagement with said first slot and for coupling said first armto said base, and said second arm having a second coupling member forsliding engagement with said second slot and for coupling said secondarm to said base, said first and second arms being foldable from a firstsubstantially flat position to a second folded, upright position; and alocking device for locking said first and second arms in said folded,upright position.
 23. The device of claim 22, further comprising anactuating device coupled to said first and second arms forsimultaneously and substantially symmetrically sliding said outer endsof said first and second arms inwardly toward said center panel to foldeach of said arms to said second folded upright position having asubstantially inverted V-shaped configuration to engage and support apatient's head.
 24. The immobilizing device of claim 23, wherein saidactuating device is a flexible member and is coupled to said first andsecond coupling members.
 25. The immobilizing device of claim 23,wherein said actuating device is a flexible cord.
 26. The immobilizingdevice of claim 23, further comprising a guide member positioned on abottom face of said base for guiding said actuating device.
 27. Theimmobilizing device of claim 26, wherein said guide member has a firstend substantially aligned inwardly with respect to said tabs, anelongated slot having guiding surfaces extending inwardly from saidfirst end toward a second end of said guide member, wherein saidactuating member passes through said slot from said first end to saidsecond end, whereby pulling said actuating device through said slotpulls the ends of said arms toward said center panel to said foldedposition.
 28. The immobilizing device of claim 23, further comprising abottom panel adjacent a bottom side of said guide member and said base,said bottom panel having an aperture, and wherein an end portion of saidactuating member extends through said aperture to form a loop, andwherein a second portion of said actuating member passes through saidloop, whereby said loop can be tightened around said second portion tolock the position of said actuating member.
 29. The immobilizing deviceof claim 23, wherein said actuating member includes a body portionhaving a plurality of teeth and a pair of flexible legs, each of saidlegs being coupled to a respective arm of said immobilizing member, andwherein said immobilizing device includes an aperture, said body portionof said actuating member passing through said aperture whereby the teethof said body portion engage a side wall of said aperture to lock saidactuating member and lock said arms in said folded position.
 30. Theimmobilizing device of claim 22, wherein said coupling members of saidfirst and second coupling members include a neck portion, and a headportion having a substantially trapezoidal shape, and wherein said slotsinlaid base include a plurality of inwardly directed ratcheting teethfor interlocking with said head of said coupling member and limitingsliding movement of said coupling members in said slots.
 31. A blank forforming a cervical immobilizing device, said blank comprising: a firstpanel having first and second longitudinal ends and a center panelhaving longitudinal ends, a first flap coupled to said first end of saidcenter panel by a first fold line and having a second fold linesubstantially parallel to said first fold line and spaced from saidfirst fold line to define an inner and an outer panel; a second flapcoupled to said second end of said center panel by a first fold line andhaving a second fold line substantially parallel and spaced from saidfirst line to define an inner and an outer panel; and a second panelhaving longitudinal ends and first and second longitudinal side edges,said first longitudinal side edge being coupled to said first panel by afold line.
 32. The blank of claim 31, further comprising a first tabcoupled to said outer panel of said first flap; a second tab coupled tosaid outer panel of said second flap; a connecting panel coupled to alongitudinal side of said center panel by a fold line and coupled tosaid second panel by a fold line; said second panel having at least onefirst aperture adjacent said first flap and at least one second apertureadjacent said second flap.
 33. The blank of claim 32, wherein said firsttab extends from an outer edge of said first flap, said second tabextends from an outer edge of said second flap, said second panelcomprising a plurality of said first and second apertures, said firstand second apertures being dimensioned to receive said first and secondtabs, respectively.
 34. The blank of claim 32, wherein said longitudinalends of said first and second tabs include at least one aperture forreceiving an actuating member, said center panel includes an aperture,said aperture defined by first and second side wall portions for guidingsaid actuating member, and said second panel having a center aperturedimensioned for receiving said actuating member.
 35. The blank of claim32, wherein said outer panels of said first and second flaps include acut line to define said first and second tabs, said first and secondtabs having a neck portion coupled to said respective outer panels by afold line and a head portion coupled to said neck portion by a foldline, wherein said head portion has a width greater than a width of saidneck portion.
 36. The blank of claim 35, wherein said first and secondflaps include an end portion coupled to said outer panels by a fold lineextending parallel to said second fold line.
 37. The blank of claim 35,wherein said first and second apertures in said second panel compriseelongated slots extending in longitudinal direction with respect to saidlongitudinal dimension of said second panel, and said elongated slotshave a width less than the width of said head and at least the width ofsaid neck portion of said tabs.
 38. The blank of claim 37, wherein saidelongated slots have a substantially T-shape.
 39. The blank of claim 33,further comprising a second connecting panel coupled to said secondlongitudinal side edge of said second panel, and a third panel having afirst longitudinal edge coupled to said second connecting panel by afold line, said third panel including first and second longitudinalslots having a length substantially equal to said slots of said secondpanel and width at least as great as said width of said heads of saidtabs.
 40. The blank of claim 37, comprising an end panel having a firstlongitudinal edge coupled to a second longitudinal edge of said thirdpanel by a fold line, said end panel having an elongated slot extendinginwardly from a second longitudinal edge of said end panel toward saidfold line, said slot being defined by end walls terminating at convexedges adjacent said second longitudinal end.
 41. The blank of claim 40,wherein said third panel has a central aperture proximate said endpanel.
 42. The blank of claim 40, wherein said fold line coupling saidend panel to said third panel includes a central aperture.
 43. The blankof claim 39, wherein said first and second tabs include a neck portioncoupled to said respective outer panel by said fold line and a headportion coupled to said neck portion by a fold line, wherein said headportion has a substantially trapezoidal shape, and wherein saidlongitudinal slots in said third panel are defined by side edges havinga plurality of teeth dimensioned for interlocking with said head of saidtabs.
 44. The blank of claim 31, wherein said fold line coupling saidfirst panel to said second panel includes a longitudinal slit.